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Diabetes aktuell 2014; 12(5): 222-225
DOI: 10.1055/s-0034-1393717
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© Georg Thieme Verlag Stuttgart · New York

Zucker im Urin – Wandel vom Zeichen der Erkrankung zum Zeichen der aktiven Diabetesbehandlung?

Glucosuria – SGLT-2-inhibitors
Gottfried Rudofsky
1   Kantonsspital Olten, Olten
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Publication History

Publication Date:
12 September 2014 (online)

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Mit den Sodium-Glucose Linked Transporter (SGLT)-2 steht seit 2012 eine neue Substanzgruppe zur Verfügung, deren Wirkweise auf einer Inhibierung der renalen Glukoserückresorption beruht. Beim Patienten mit Diabetes und guter Nierenfunktion ermöglicht dieser Insulin-unabhängige Therapieansatz einen breiten Einsatz, um den Blutzucker effektiv, hypoglykämiearm und langfristig zu senken. Dieser antihyperglykämische Effekt auf die Nüchtern- und postprandialen Glukosewerte ist kombiniert mit einer moderaten Gewichts- und Blutdruckreduktion, was ebenfalls bei den meisten behandelten Patienten von Vorteil sein dürfte. Da noch keine Endpunktstudien zu der Substanzklasse vorliegen, die einen für den Patienten günstigen Effekt über einen rein antihyperglykämischen Effekt hinaus zeigen und eine Unbedenklichkeit auch in der langfristigen Anwendung belegen, ist ein verantwortungsvoller Umgang angezeigt.

Since 2012 with Sodium-Glucose Linked Transporter (SGLT)-2 inhibitors there is a new class of antidiabetic agents avaiable whose action is based on the inhibition of the glucose reabsorption pathway in the kidney resulting in ouvert glucosuria and a consequent control of glucose in patients with diabetes. Apart from lowering fasting and postprandial glucose levels effectively without causing hypoglycemia, SGLT-2-inhibitors also reduce body weight and systolic blood pressure, where most of the treated patients might benefit as well. Since up to now no effects beyond their glucose lowering potential e. g. on cardiovascular events or diabetic complications have been shown, a careful use of these new agents is recommended.

Key words

Diabetes mellitus - SGLT-2-inhibitors - inhibition of glucose reabsorption in kidney - glucosuria
 

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